Assessing the accuracy of lily and Semmes-Weinstein monofilaments in diabetic neuropathy

  Background: Diabetic neuropathy (DN) is the most common complication of diabetes. In order to manage DN effectively, it is necessary to formulate an accurate diagnosis and monitor subjects regularly.   Objective: The aim of this study was to evaluate the accuracy of the lily and Semmes-Weinstein monofilaments examination (SWME) for diabetic peripheral neuropathy (DPN) screening.   Methods: In this study, 150 patients with type 2 diabetes who have been referred to the Golestan Diabetes Clinic in 2010, were recruited and questioned about 13 subjective symptoms of DN. They were examined using two types of monofilaments (SWME and lily). EMG-NCV was performed as golden test. The Sensitivity and specificity of the SWME and lily were analyzed by descriptive tests.   Findings: The most common subjective symptoms were paraesthesia of both feet, pain in feet, burning sensation and numbness in the extremities. The sensitivity of SWME was 35.9-48.7% at sites 1-3, whereas the sensitivity of lilly was 35.9-53.8%. The overall sensitivity and specificity of SWME and lilly at the sites 1 and 3 were 46.2% and 78.4%, respectively while they were 48.7 % and 77.5 % at the sites 1-3.   Conclusion: Using monofilaments were found to be simple, cheap and suitable methods for detection of sensory neuropathy in clinical examinations. Hence, we recommend neuropathy screening in patients as soon as the diagnosis of diabetes.